Medical Horror Show

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http://cbc.ca//news/viewpoint/columns_omalley/martin991201.html Medical Horror

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Medical Horror Shows

Martin O'Malley

CBC News Online

 

In our science and technology section we recently carried a story titled,

" Medical mistakes killing thousands. " It dealt with a survey conducted by the

Institute of Medicine in the United States, part of the National Academy of

Sciences in Washington. The survey estimated that medical mistakes kill between

44,000 and 100,000 people a year.

 

Even using the lower figure, this means more people are killed by medical

mistakes every year in the United States than by highway accidents, breast

cancer or AIDS. I expect the situation to be similar, proportionately, in

Canada. Hospitals are dangerous places where many things can and often do go

terribly wrong. There is a word for it: iatrogenic. It is the word used to

describe medical calamities " induced inadvertently by a physician or surgeon or

by medical treatment or diagnostic procedures. "

 

With health cutbacks and short-staffed hospitals, people who must go to hospital

are advised these days to bring with them a " patient advocate, " a friend or

relative who will run interference for them, and perhaps save their lives.

 

A while ago I spent two years in a hospital researching a book on medical care.

It would not be fair to single out the hospital because my research took place

15 years ago. Besides, iatrogenic calamities happen in all hospitals, big or

small, in every city in the country. This story came to me in the public

relations department, where a woman wrote to the director to tell the story of

what happened to her mother.

 

Her mother was 72 years old. On a brisk, wintry day before Christmas she went

shopping and fainted in a downtown department store. She was taken to hospital

where, following a Kafkaesque series of blunders, she died. Three months later,

the daughter wrote to the hospital's public relations department trying to find

an explanation.

 

" No one seems to know anything, " she said in her letter. " I am not interested in

starting a lawsuit against the hospital to gain some satisfaction and peace of

mind. All I want to do is speak with those responsible for my mother's care. "

 

Here is what happened.

 

Someone at the hospital had called the daughter to tell her of her mother's

accident when her mother was brought into Emergency. When the daughter arrived

at the hospital, a doctor told her that her mother had only bruised her forehead

when she fell but she should stay in hospital for a few days. The daughter

agreed and tried to calm her mother, who wanted desperately to go home.

 

Four days later, the daughter arrived to visit her mother and heard that she had

been transferred to Orthopedics. She asked a nurse what this was all about and

the nurse said she wasn't sure but thought it had " something to do with a broken

hip. " Apparently her mother had gone for a walk and slipped on some loose tiles

left in a hospital corridor by maintenance workers. The daughter asked to see a

doctor -- she wanted to know if the broken hip required surgery -- but a nurse

told her all the doctors were in operating rooms.

 

That night, after dinner, a nurse called to say her mother had suffered a heart

attack. The daughter rushed to the hospital and found her mother in Intensive

Care, conscious but terrified of all the machinery around her. A few days later,

the mother was transferred from Intensive Care to Urology, not because she had

any urological problems but because there were no other beds available.

 

The daughter arrived the next morning, this time to find her mother unconscious.

She called for help and a nurse arrived, then a doctor. They pushed the daughter

out of the room and told her to wait outside in the corridor while they examined

her mother. Minutes later, the nurse and the doctor came out and said her mother

had probably suffered a stroke and a specialist would have to be called. And,

no, she couldn't go into the room.

 

The specialist arrived an hour later, went into the room, stayed about two

minutes, then started yelling at the nurse. " Why did you call me to look at a

dead patient? This better not happen again! " he shouted, then walked off stiffly

down the corridor.

 

The daughter's letter prompted an official inquiry, which determined:

 

 

* A CAT scan had not been performed when the patient arrived because of

repairs being done to the scanner.

* The patient had not been examined by an attending physician during her

entire stay.

* An autopsy report, completed three weeks after the autopsy, indicated the

patient died of heart failure following a stroke.

* X-rays of the broken hip indicated that surgery should have been scheduled

promptly.

* The patient's lab tests were never located.

* Maintenance crews repairing floors had been reprimanded on two previous

occasions for not removing materials after their work.

* The identity of the specialist could not be determined because the nurse

who attended at the woman's death had only been working at the hospital for a

week and had not completed her notes.

* When the patient kept asking to go home, a resident prescribed a sedative,

which was administered an hour before she fell and broke her hip.

 

It could happen to you.

 

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